Naltrexone promising for treating kleptomania

A man lies on a table with a glass of alcohol and a half-filled bottle in the foreground, in this undated handout image.

NEW YORK (Reuters Health) - Naltrexone, a drug commonly used to treat alcoholism and drug addiction, reduces stealing urges and associated behavior in individuals with kleptomania, according to study results published in the current issue of Biological Psychiatry.

"Kleptomania appears to share many...similarities to substance use disorders: urges or cravings, tolerances, withdrawal, repeated unsuccessful attempts to cut back or stop, and impairment in areas of life functioning," Dr. Jon E. Grant and colleagues at the University of Minnesota School of Medicine, Minneapolis, point out.

Naltrexone belongs to a class of drugs called opioid antagonists, which among other functions, diminish "stealing-related excitement and cravings," they note.

In an 8-week clinical trial, the researchers examined the effectiveness and tolerability of naltrexone in 25 adults with kleptomania who were randomly assigned to receive naltrexone or placebo. Twenty-three subjects completed the study.

Significantly greater reductions in obsessive-compulsive characteristics associated with kleptomania were observed among patients assigned to naltrexone compared with those treated with placebo. The average effective dose of naltrexone was 116.7 milligrams per day.

Compared with patients receiving placebo, those taking naltrexone had significantly greater reductions in kleptomania symptoms and in overall kleptomania severity. The naltrexone group also had an increased positive response on measures of psychosocial functioning, as well as greater reductions in measures of depression and anxiety.

Most adverse drug affects were mild to moderate in intensity and occurred during the first week of treatment.

The effectiveness of naltrexone in this study provides additional support to the hypothesis that pharmacological manipulation of the brain's opiate system can target the primary symptoms of kleptomania, Grant and colleagues conclude.

SOURCE: Biological Psychiatry, April 1, 2009.